Time‐loss and recurrence of lateral ligament ankle sprains in male elite football: A systematic review and meta‐analysis

A literature search was conducted to systematically review and meta‐analyze time‐loss and recurrence rate of lateral ankle sprains (LAS) in male professional football players. Six electronic databases (PubMed, Scopus, Web of Science, PEDRO, CINAHL, and Cochrane) were searched independently, separately both for time‐loss and recurrence from inception until April 30, 2021. In addition, reference lists were screened manually to find additional literature. Cohort studies, case reports, case–control studies and RCT in English language of male professional football players (aged more than 16 years) for which data on time‐loss or recurrence rates of LAS were available were included. A total of 13 (recurrence) and 12 (time‐loss) studies met the inclusion criteria. The total sample size of the recurrence studies was 36,201 participants (44,404 overall initial injuries; 7944 initial ankle sprain [AS] injuries, 1193 recurrent AS injuries). 16,442 professional football players (4893 initial AS injuries; 748 recurrent AS injuries) were meta‐analyzed. A recurrence rate of 17.11% (95% CI: 13.31–20.92%; df = 12; Q = 19.53; I(2) = 38.57%) based on the random‐effects model was determined. A total of 7736 participants were part of the time‐loss studies (35,888 total injuries; 4848 total ankle injuries; 3370 AS injuries). Out of the 7736 participants, 7337 participants met the inclusion criteria with a total of 3346 AS injuries. The average time‐loss was 15 days (weighted mean: 15.92; median: 14.95; min: 9.55; max: 52.9). We determined a priori considerable heterogeneity (CI: 18.15–22.08; df = 11; Q = 158; I(2) = 93%), so that the data on time‐loss are only presented descriptively. There is an average time‐loss of 15 days per LAS and a recurrence rate of 17%. LAS is one of the most common types of injury with higher recurrence rates than ACL injuries (9%–12%) in professional football players. Nevertheless, the focus of research in recent years has been mostly on ACL injuries. However, the high recurrence rates and long‐term consequences show the necessity for research in the field of LAS in elite football. Yet, heterogeneous data lead to difficulties concerning the aspect of comparability.